口腔颌面部损伤课件

口腔颌面部损伤Dr.SteveGFShenOralandMaxillofacialSurgerySchoolofStomatologyShanghaiNinthPeople’sHospitalShanghaiSecondMedicalUniversityOral&MaxillofacialTraumaChapter7口腔颌面部损伤Vocabularyabrasion擦伤adjacenttooth邻牙alar鼻翼的antibiotics抗生素anti-infection抗感染anuria无尿archbar牙弓夹板arterial动脉的asphyxia窒息bandage绑带bitewound咬伤bloodsupply血供bustup斗殴capillary毛细血管的cerebral脑的cerebralfluid脑脊液cervical颈的concussion震荡contaminate污染contusion挫伤2024/11/12口腔颌面部损伤Vocabularycyanosis发绀debridement清创术alveolarprocess齿槽突dentalpulp牙髓devitalize失活dysfunction功能异常dysphoria烦躁不安edema水肿esthetic美学的exfoliate脱落exsanguine失血的extradural硬脑膜外的extrinsicforce外力extrusion突出的facialnerve面神经foreignbody异物fracture骨折gingival牙龈的hematoma血肿hemostasia止血，止血法2024/11/13口腔颌面部损伤Vocabularyhemostat止血钳hyponuria少尿hypopnea低通气incisedwound切割伤inhale吸气inspiratoryasphyxia吸入性窒息intracranial颅内的intubation插管lacerate撕裂laceration撕裂ligation结扎luxation脱位malocclusion咬合错乱mandible下颌骨mastication咀嚼maxilla上颌骨maxillofacial颌面的mouthopening张口度nasalcavity鼻腔obliviscence遗忘2024/11/14口腔颌面部损伤Vocabularyobstructiveasphyxia阻塞性窒息occlusion咬合oralcavity口腔oralhygiene口腔卫生orbit眼眶pain-killer止痛剂paralysis瘫痪paranasalsinus副鼻窦parotidgland腮腺percussion叩诊periodontalligament牙周韧带petechia瘀斑，瘀点pharyngealcavity咽腔plasma血浆psychological心理的psychotherapy精神疗法rabies狂犬病regenerate再生reimplantation再植rescue营救，抢救2024/11/15口腔颌面部损伤Vocabularyrespiratory呼吸的saliva涎液，唾液salivary涎液的shock休克skullbase颅底stomatognathic口颌的subdermal皮下的swallow吞咽sweat出汗tetanus破伤风toothache牙疼toxicshock中毒性休克transportation运输，搬运trauma损伤，外伤trigeminalnerve三叉神经unconsciousness神志不清upperairway上呼吸道vaccination接种疫苗venous静脉的viscera内脏2024/11/16口腔颌面部损伤Definitionoftraumatrauma

noun[CorU]severeemotionalshockandpaincausedbyanextremelyupsettingexperience:

thetraumaofmarriagebreakdown

Hehadpsychotherapytohelphimdealwithhischildhoodtraumas.SPECIALIZEDasevereinjury,usuallycausedbyaviolentattackoranaccident(fromCambridgeAdvancedLearner'sDictionary)2024/11/17口腔颌面部损伤Section1IntroductionWarIncidenceTrafficAccidentSportsFallingBustupLaborinjury2024/11/18口腔颌面部损伤24万14.2万人10亿元1993年1997年2001年30万19万人18.5亿元75.5万54.6万人3.09bRMBFinancialLoss致伤人数NooftrafficaccidentTrafficAccident2024/11/19口腔颌面部损伤TrafficAccident2024/11/110口腔颌面部损伤

Combinedinjurytootherviscera-Fataltolife

Damagetomaxillofacialstructure

Stomatognathicdysfunction

Facialestheticproblem

PsychologicaltraumaEffectofTraumaontheHumanBody2024/11/111口腔颌面部损伤1.RichbloodsupplySection2CharacteristicsofOMFTrauma2024/11/112口腔颌面部损伤DebridementTime:24–48hTendto hematoma,edemaRespiratorytractAsphyxiaAbilitytoanti-infection,regenerationWoundhealing1.Richbloodsupply2024/11/113口腔颌面部损伤

Cerebralconcussion

Cerebralcontusion

Intracranialhematoma

Skullbasefracture

Increaseinfectiousincidence

Malocclusioncaused-Diagnosis

Occlusionregained-Treatment2.Relationshipbtwtooth&OMFtrauma3.Cranio-cerebraltrauma2024/11/114口腔颌面部损伤Mouthopening,mastication,swallowing4.Cervicaltrauma5.Effectonbreathing6.EffectofondigastricsystemBleedingParalysis 瘫痪LeadingdifficultybreathingdietworseoralhygieneAsphyxia窒息2024/11/115口腔颌面部损伤7.Multi-sinus

-contamination

InfectionOralcavityNasalcavityPharyngealcavityOrbitParanasalsinusBacteriaTempHumidity2024/11/116口腔颌面部损伤8.DamagetospecificstructureParotidGlandFacialN.TrigeminalN.SalivaryfistulaFacialparalysisRegionalnumbness2024/11/117口腔颌面部损伤9.FacialDefect

FacialcontourPsychologicaltrauma2024/11/118口腔颌面部损伤EvaluatetraumasoonIdentifythekeytrauma,managethefatalfirstCarefulhistorytaking,thoroughphysicalexamRescueintimeManagementinorderGeneralRulesSection3Rescue2024/11/119口腔颌面部损伤1.PreventionofAsphyxiaSection3Rescue2024/11/120口腔颌面部损伤Dysphoria,sweating,inhalingrespirationDifficulttoinhale,hypopnea,nasalalarmovement,labialcyanosisThreeconcavesigns、Rapidbreathing,weakpulse,decreasedBPPupilsdiluted,Noreflectiontolight1.1ClinicalfeaturesofasphyxiaProdrome2024/11/121口腔颌面部损伤1.2

EtiologyofAsphyxia

ForeignbodyobstructionInspiratoryAsphyxiaLowAirwaySwellingForeignbodyBlood,salivaVomitUpperairwayTissuedislocation

ObstructiveAsphyxia2024/11/122口腔颌面部损伤1.3

RescueofAsphyxiaClearforeignbodyinupperairwaySuspendmaxillaIntubationHoldthetongueoutObstructiveAsphyxia吸入性窒息气管切开术2024/11/123口腔颌面部损伤

2.HemostasiaTwosteps：JudgebleedingsituationChoosethewaytostopbleedingSection3Rescue2024/11/124口腔颌面部损伤2.1

JudgebleedingsituationThreecategoriesArterialCapillaryVenousBasedonorigin2024/11/125口腔颌面部损伤压迫止血指压止血法包扎止血法填塞止血法结扎止血法药物止血法2.2

Methodsofhemostat2024/11/126口腔颌面部损伤3.Anti-shocktreatment(2)

Purposeofanti-shock(1)

Definition&Classification

TraumaticshockExsanguineshock

>20%BodyweightToxicshockInfectiousshock

Restorecirculation2024/11/127口腔颌面部损伤(4)

PrinciplesofTreatment

(3)

FeaturesofShockEarlystage:Dysphoria,quick&superficialbreath,sweating,palenessMiddlestage:Tingletosupression,emotionalfaint,unconsciousness,decreaseBP,labialpalenessLatestage:weakerpulsation,unmeasurableBP,hyponuria,anuria<30ml/hHemostasis,bloodtransfusion,paincontrol,fluidtransfusion,sedation2024/11/128口腔颌面部损伤(1)

Judgement4.CombinedCraniocerebralInjuriesConsciousness,pulse,BP,respiration,pupil(2)Earlydiscovery,earlymanagementRetrogradeobliviscence CerebralconcussionIntermediatewake-up ExtraduralhematomaCerebralfluidleak Skullbasefracture2024/11/129口腔颌面部损伤2024/11/130口腔颌面部损伤DebridementWoundclosureAntibiotics5.PreventionofInfection6.Bandage&Transportation2024/11/131口腔颌面部损伤

Section4SoftTissueTrauma2024/11/132口腔颌面部损伤Abrasions 擦伤Contusions 挫伤Contusions&Lacerations 挫裂伤Incised&PunctureWound 切割伤及刺伤BiteWound

咬伤TypesofinjuriesSection4SoftTissueTrauma2024/11/133口腔颌面部损伤Character:Irregularwoundedge,foreignbody,pain,oozing&yellowishplasmaoozingManagement:Debridement,removeforeignbody,Drywound,drainwheninfected1.AbrasionsProperty:roughsurfaceEpidermis&superficialdermis2024/11/134口腔颌面部损伤1.Abrasions2024/11/135口腔颌面部损伤2.ContusionsCharater:petechia,swelling,painManagement:

HemostasisPain-killerPreventionofinfectionHematomaresorptionRe-establishmentoffunctionProperty:bluntmaterial&felltohardobjectSubdermaltissue(noopenwound)2024/11/136口腔颌面部损伤Property:Bluntobjectwithhighmechanicalforce3.Contusions&LacerationsCharacterIrregularwoundedge,saw-toothedBiglacerationw/wonecrotictissue&openfracturesManagementDebridementWoundClosureSofttissue2024/11/137口腔颌面部损伤3.Contusions&Lacerations2024/11/138口腔颌面部损伤Property:Sharpobjectorinstruments4.Incised&PunctureWoundCharater

RegularwoundedgeBleedingSmallaccess,butdeepwoundManagementDebridementWoundclosureSofttissue2024/11/139口腔颌面部损伤Property:Animal(Wolf,dog,Bear)orhumanbeingsCharacterToothtracedHeavycontaminationTendtoinfectionManagementThoroughdebridementInfectioncontrolSkingraftaftergranulartissueregeneratedVaccinationofTetanus,Rabies5.BiteWound2024/11/140口腔颌面部损伤DefinitionDebridement

MainEntry:de·bride·ment

Pronunciation:di-'brEd-m&nt,dA-,-"mänt,dA-brEd-'män

Function:

noun

Etymology:Frenchdébridement,fromdébridertoremoveadhesions,literally,tounbridle,fromMiddleFrenchdesbrider,fromdes-de-+bridebridle,fromMiddleHighGermanbrIdel--moreatBRIDLE

:thesurgicalremovaloflacerated,devitalized,orcontaminatedtissue2024/11/141口腔颌面部损伤Protocol1.washwound

Time：6--12h

Solution:soapwater,saline,hydrogendioxideDebridement3.Closure2.Cleanwound

Removalofforeignbody Trimmingofnecrotictissue2024/11/142口腔颌面部损伤2024/11/143口腔颌面部损伤CheekinjuriesPalateinjuriesInjuriesatotherregionsManagementofsofttissureinjuriesTongueinjuriesLengthmaintain,longitudinalclosureIndependentclosure,buttonguesuturedominationBigneedlewithbig,depthsuturingormatricsuturing2024/11/144口腔颌面部损伤Managementofsofttissureinjuries2024/11/145口腔颌面部损伤2024/11/146口腔颌面部损伤Section5InjuryofTeethandDentalAlveolarProcess2024/11/147口腔颌面部损伤1.Toothinjuries

1.1ContusionofTeethEtiology:Extrinsicforce blunttoothinjuries

PeriodontalligamentsordentalpulpCharacter:ExtrusionoftoothMobilityPercussion&ToothachewhenchewingManagementToothrestToothgroundSimpleligation2024/11/148口腔颌面部损伤1.Toothinjuries

1.2LuxationofTeethClassificationCharacterToothdislocatedorexfoliatedManagementToothprotectionpriorityReductionFixationReimplantationPartialluxationCompleteluxation-Toothdislocation-Semiluxation-Intrusivemovement2024/11/149口腔颌面部损伤Gingivalorlabialswelling,lacerationAdjacentteethoralveolarprocessmovementwhenoneaffec